Cardiology MCQ 52

Q. Ortner's syndrome occurs due to?
A. Single ventricle with normally related great vessels
B. Anomalous left coronary artery from pulmonary artery
C. Dilated left atrium causing compression of trachea
D. Enlarged pulmonary artery compressing recurrent laryngeal nerve

Answer: D. Enlarged pulmonary artery compressing recurrent laryngeal nerve

Explanation:

Ortner's syndrome is a rare condition and occurs because of compression of recurrent laryngeal nerve by cardiovascular structures. Most common cause is dilated left atrium due to severe MS. However, other causes include enlarged pulmonary artery, thoracic aortic aneurysms, aberrant subclavian artery which may cause compression of recurrent laryngeal nerve.
Note: Ortner's syndrome does not occur due to compression of trachea.

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ECG Spotter

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High heart rate

The patient contacts the doctor over phone with this report. Obviously anxious because of his high heart rate (199 beats per minute) as detected by ECG machine. Should he be worried about this and come to emergency department as soon as possible? Correct answer- ECG machine has calculated his heart rate incorrectly. Heart rate is around 100 beats per minute. Other findings in this ECG include ST segment elevation in anterior chest leads along with presence of Q waves, denoting old MI changes with possibly development of LV aneurysm. In such cases, ST segment elevation can persist for long periods. Now, should he come to emergency department? Not because of detection of high heart rate. But, if he is having symptoms such as shortness of breath or chest pain, he should visit emergency department. Otherwise, if he is asymptomatic, he can schedule a regular visit with his cardiologist.

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